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Need some advice - Cortisone Injections for Degenerative Discs?

YodamanYYodaman Posts: 11
edited 06/11/2012 - 8:41 AM in Lower Back Pain
Hello everyone, I just signed up and am now a new member although i have often been on this site, particularly the forums for the past few months. I am 19 and currently am a full time college student and live in Santa Cruz California.

Anyways, i suffered a skateboarding injury in 2008, damaging my lower spine and since then the pain has gotten progressively worse. I have seeked treatment from a wide variety of doctors and others since the accident(listed in chronological order): 2 different chiropracters, a spine specialist, Physical Therapist, PCP, Personal Trainer, and most recently a Physical Medicine and Rehabilition doctor.

Through these sources it is apparent that at least 3 of my discs in my lower spine are degenerating and i have a mild herniation in one disc. Because of this i experience muscle spasms on a daily basis which is further straining my spine. As a result of both these things my spine is now "straight as a 2x4" as one doctor put it, instead of having a natural curve.

I experience back pain almost everyday along with the discomfort, sometimes unbearable, muscle spasms. And even when i am not in pain my back always feels stiff. The chiropracters, physical therapy and personal trainer did not significantly improve the pain, i have also tried Voltaren and an oral Cortisone pack to no avail. The only thing that has provided me with real pain relief is Percocet 10/325 which i was put on after all the previosly mentioned failed.

My was receiving the Percocet from my PCP, but he abruptly left the foundation i was going to, so i havent had any percocet for almost a month now which means my pain is significantly higher and it is disrupting the quality of my life. The PM doctor said he doesnt prescribe anything but physical therapy, and i tried to get a refill today from Physician who flat out refused to give me my usual prescribed percocet, and "unenthusastically" gave me only #20 Ultram which really is barely affecting my pain levels.(it is 2a.m. and i cannot sleep b/c of the pain)

The PM&R doctor instead wants me to get a cortisone spinal injection, though he wasnt very convincing. He said to go over some papers he gave me, and go on the internet to get info on it and call him if i want to do it.

My pain for the most part was well controlled on the percocet, allowing me to hike, work, cook and do household chores. But for the past month without it, my hiking is limited to an hour and near the end of the hike im in bad pain and following the walk as well. House chores bring me pain which has caused me to do much less of them and working is limited to only 3hours a day at most. And i only cook a couple times a week now(before i would cook everyday) Considering that i dont think i will be able to get and percocet anymore the injections feel like my only option.

So it would be cool if some of you guys that have received the treatment could tell me what you think about the cortisone injections specifically for degenerative disc problems. do the side effects outweigh the benefits? what were your short term and long term results? And if there are any, what alternatives would you recommend?

Sorry for the long post. Id really appreciate some advise, or even if you have a similar situation feel free to comment.




  • If you feel muscle spasms are contributing to your problem, have you tried muscle relaxers? You need to do something to break the cycle of inflammation causing pain. I assume this would be the purpose for having an ESI. I think it would be worth trying one to see if it helps.

    Your age probably plays into the type of treatment you've received. Doctors seem very reluctant to provide strong pain pills to people under a certain age. Also, because of your age, it is wise to pursue a more permanent solution to your problems, rather than just medicating for pain.

    Discs can and do heal on their own. The injection would help with any inflammation you may have. If there is any compression on a spinal nerve, this should help to reduce the pain.

    You might also get some relief from icing the lower lumbar area several times per day and after any exercise or strenuous activity.

    It will be important to modify your activities, being sure to avoid any activity that involves bending at the waist, twisting, reaching up overhead or to the side and lifting anything heavier than about a gallon of milk or 8-10 pounds. You need to watch your posture and use good body mechanics at all times. And you might want to try acupuncture, as well.

    Is your PM doctor and the PM&R doctor one and the same??

    There is a section of the forum devoted to spinal injections. Just look under the TREATMENT heading. Also there is a lot of good information on this website written by spinal specialists. You can read about injections here:


    One of the people I see on a weekly basis lived in Santa Cruz for awhile and returns several times per year to teach a couple classes. I'll ask him if he could recommend someone that might be able to help you. I see him tomorrow, so I'll get back to you.

    Good luck.
  • Thank you for the reply. Yes i have tried a couple different muscle relaxers and am currently prescribed 1/2 Soma as needed, but i rarely ever take it because it messes me up so much. I feel drunk even when i just take half a tablet so i hate taking them and only do maybe once or twice a week and only right before i go to bed. Id rather function in pain than feeling drunk/high throughout the day.

    Also when i said PM i was referring to the Physical Medicine and Rehab doctor, and i think you were asking if i was seeing a (PM)Pain Management Doctor? I am not and dont think we even have them in Santa Cruz... not sure though. I really appreciate you trying to help me find a good doctor to go to and thatll be great if your friend can recommend one. I feel like most doctors dont understand the pain im in, and they really dont hear me out or provide me with thoroughly explained treatment plans.

    I think im going to get the injections, as it is really my only option right now, but im still not 100% sure. My personal trainer thinks there a horrible idea, he says that they will only temporarly bring me relief and in the long run be worthless. He also said that after multiple injections, the steroids can actually further cause tissue degeneration, does anyone know if this things are true?
  • I just called my insurance company and they wont cover the injections.. Does anyone know how much they are? Would they be too expensive to pay out of pocket?

    Wow, dont really know what to about this situation now. I was up till 5am last night with pain and now i dont have any treatment options. feeling pretty down.
  • I'm amazed that your insurance won't cover injections. Usually insurance companies want you to try every conceivable noninvasive treatment before they'll agree that you need surgery (not that you need surgery). I just find it very, very odd.

    So, what the heck do they expect you to do? Have you consulted with a spine specialist/surgeon? Maybe you should go to the top of the page and use the "Find a doctor" feature and see what comes up. I use a spine center that includes physio docs, surgeons, and onsite PT.

  • I dont get it either. And this is the 2nd insurance company to deny the injections. My old insurance company from last year said they wont cover it because they dont cover "experimental procedures". And my new insurance is even worse, i guess i barely get any procedure coverage at all including CT scans MRI's etc, so no injection coverage. The spine specialist i saw only exclusively does injections so i cant get any help from him. Ill try and use the doctor finder and see if i can find any other specialists in the area i guess.
  • I am uninsured and paid out-of-pocket for a caudal ESI last week. The cost was $2200. It covered the doctor's fee ($1100) and the facility fee ($1100). Still not sure it worked. :(
  • Hi and welcome,

    Has your doctor considered trying an oral steroid instead? I know the ESI (epidural) injection target reducing swelling/inflammation. An oral steroid like a Medrol pak (step pack) might be an option to try before the ESI.

    I'm not sure why your insurance company believes that to be experimental. It's actually quite an accepted procedure...perhaps the 'CPT code" being submitted is not substantiated or the wrong doctor is prescribing it? I would think an orthospine specialist or Neurosurgeon would the appropriate person to do that. Have you had an MRI that would indicate that ESI shot would help?


    I would agree on modifying your activities. Twisting, bending (i.e. hiking up steep hills), and lifting will aggravate your situation. Icing is key in 10 min increments.

    As for muscle relaxer - not sure which you've tried but there are a few types. Valium can make you feel drunk but I think Norflex (orphenadrine) is a little less strong but you have to take it with food in your belly b/c it causes dizziness too.

    Good luck.
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